Studies have shown a positive correlation between the final position of implanted aortic valve and the need for permanent pacemaker insertion following TAVI resulted in increased long-term mortality in this subset. The new cusp overlap technique is supposed to increase the chance for appropriate valve implantation in the native aortic annulus reducing permanent pacemaker rate. Cusp overlap technique significantly influenced the implantation depth resulting in higher implantation, while lower implantation depth resulted in a significantly higher amount of permanent PM implantation.